Selecting medical insurance to best suit your needs can be complicated. With so many options, plans, and network types available, it’s vital to know that you’ll be covered when you need it most.
This article offers some practical tips to help you make an informed choice.
Where to Start
Before you select a plan, get an idea of what you’ll need. The experts at MedicareHaven recommend that you review your previous year’s medical history and then estimate your requirements for the next one.
List all the regular check-ups your family needs at your general practitioner or a specialist if you suffer from a specific condition. Add in prescriptions and monthly pharmacy costs for chronic medication.
Don’t forget to plan for significant life events like starting a family or additional cost and care if you have an elective procedure coming up. While there’s no way to accurately predict what you’ll need, it gives you an excellent base to start from.
Questions to Ask
Knowing what coverage you may need, you should have a figure in mind. Match that to your household budget available for medical expenses and insurance or your employer’s health care options.
Then start asking questions from each provider or compare the benefits of all the plans you’re considering. Depending on your expected health cover needs, check if the following services are included.
Emergency Care
Almost all plans include emergency room services and care. You’re not required to get prior approval from your medical insurance in the event of an accident or life-threatening incident.
However, once you’re stable, what happens after that may vary depending on your level of cover for hospitalization, specialists, and rehabilitation care.
Doctors and Specialists
You’re likely to get the best deal if your doctor has a contract with your health plan. It’s known as an “in-network” provider.
This option usually has a lower out-of-pocket cost, but it may have an annual limit or threshold. You can still consult other doctors or specialists, but know that there may be additional bills to pay from your side.
Look out for copayments or coinsurance clauses and the deductibles. These amounts are what you’ll have to cover before your insurer pays for certain health services.
Remember, coverage doesn’t start until you pay your first premium. Be mindful that there may be a waiting period, initial exclusions, or additional conditions applicable to specific procedures or services.
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Pharmacies and Prescriptions
Much like doctors, pharmacies can also be contracted to insurers as “in-network” service providers. Understand what’s covered and pay specific attention to the details around repeat prescriptions or chronic medications
Dental and Eyecare
Dental care and optometry are often not covered by mainstream plans. If your family requires extra care over and above annual check-ups, it’s best to invest in additional insurance to cover their needs.
Final Thoughts
Take the stress out of selecting medical insurance by planning. Review your medical history and records to get an estimate of your future needs.
When comparing plans, it’s good to consider the total health package. Check what’s covered and pay careful attention to exclusions, waiting periods, and other terms and conditions. Then cross-check that against your anticipated annual wellbeing requirements.
Don’t only look at your monthly premium as the final cost. Add up all the extra out of pocket amounts and prepayments too. It’ll help you identify the plan that best suits your family’s needs and your budget.